A Cochrane review [Abstract] 1 included one randomised, double-blind, placebo-controlled, cross-over trial with 45 subjects with burn injuries. The study examined the addition of lidocaine infusions to patient-controlled analgesia (PCA) morphine as compared to placebo during wound care procedures (i.e. dressing changes and/or debridement). Subjective pain ratings as measured by the verbal rating scale increased during procedures for both treatment arms, however, the increase was less for the lidocaine treatment arm. There were no significant clinical or statistical differences regarding the effects of lidocaine and placebo on opioid requests and consumption, anxiety or level of satisfaction during a wound care procedure.
Comment: The quality of evidence is downgraded by indirectness (the study was conducted in a burns centre where opioid-based pain management has been optimised), and by imprecise results (few patients).
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